Organization
GIFTED PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NYEDIANG ATEGHANG CRNP (MANAGER/OWNER)
(301) 357-1167
Entity
Organization
Contact information
Practice address
3060 MITCHELLVILLE RD, STE 106A, BOWIE, MD 20716
(301) 357-1167
Mailing address
3060 MITCHELLVILLE RD, STE 106A, BOWIE, MD 20716
(301) 357-1167
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881911400
—
MD
Enumeration date
10/07/2022
Last updated
04/08/2025
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